Medically tailored meals improved high blood pressure, Type 2 diabetes and diet in adults: Study

An 8-month program providing medically tailored meals improved diet quality and access to healthy food for adults with Type 2 diabetes and high blood pressure. It also enhanced cardiometabolic health (heart, blood vessels and metabolism) by lowering blood pressure and blood sugar, according to new, independent preliminary research to be presented at the American Heart Association’s Scientific Sessions 2026. The meeting, Nov. 6-9, in Chicago, is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science.

The research also found that gradually reducing the number of meals that participants received each month did not decrease the initiative’s health benefits when complemented with a heart health curriculum focused on healthy eating at home. Overall, the findings suggest that expanding access to programs that provide medically tailored meals for people with chronic health conditions could help to prevent the worsening of their health. Usually, food is medicine interventions have focused on people with advanced or terminal conditions. This study suggests earlier introduction of such programs and a focus on preventing the progression of cardiometabolic health diseases could be more impactful, researchers said.

More than half of adults in the U.S. have poor-quality diets (suboptimal intake of fruits, vegetables, whole grains, seafood, omega-3 fats and over-intake of processed meats, sugar-sweetened beverages and sodium). Poor diet is a leading risk factor for cardiometabolic disease, according to the American Heart Association’s 2025 Scientific Statement: A Systematic Review of “Food Is Medicine” Randomized Controlled Trials for Noncommunicable Disease in the United States. Food insecurity, which is feeling uncertain of having or unable to acquire enough food because of a lack of money or other resources, affected nearly 14% (18.3 million) of U.S. households in 2024, according to the U.S. Department of Agriculture.

Together, food insecurity and poor-quality diet can lead to obesity, which is a major risk factor for heart disease, stroke, high blood pressure, Type 2 diabetes and many cancers.

As part of the American Heart Association’s Health Care by Food initiative, which funded this project, researchers studied the effects of an 8-month medically tailored meal intervention program on diet quality and cardiometabolic health in adults with coexisting Type 2 diabetes and high blood pressure. Researchers also tested different medically tailored meal “dosing” levels to determine if a less-costly, gradual “dosing down” approach towards the end of the program complemented by an engaging education program on heart health that included nutrition counseling, cooking demonstrations and healthy recipes and ingredients would be as effective as a standard intervention dose.

“Prior studies have not examined how the number of meals provided each week, as part of a food is medicine program, influences health outcomes and what would constitute a cost-effective dose,” said lead study author Nour Makarem, Ph.D., FAHA, assistant professor of epidemiology and co-director of the Chronic Disease Unit at Columbia University Irving Medical Center’s Mailman School of Public Health in New York City. “This study found that food is medicine programs, when complemented by adequate heart health promotion efforts, may be impactful for prevention and could meaningfully improve health outcomes in adults at high risk for heart disease, particularly for people with limited resources and/or access to healthy foods and even with gradual dosing down of the meals over time.”

More than 100 adults were enrolled in the study. Half received standard dosing: 10 meals a week for 8 months, while the other half received standard dosing for the first 3 months, followed by a gradual dose reduction of one fewer medically tailored meals per month over the next 5 months, ending with five medically tailored meals per week during the last month of the program. Both groups received nutrition counseling with a dietitian and an interactive heart health education program that included the American Heart Association’s Life’s Essential 8, as well as culturally responsive cooking demonstrations, fresh produce and healthy seasonings, and other ingredients to support healthy eating habits at home that complemented the healthy diet provided by the home-delivered meals.

What are the study’s main findings?

• After 8 months, overall diet quality improved in both groups. Researchers noted a 3-point improvement on a scale measuring alignment with the heart-healthy, Mediterranean-style eating pattern.

• Using a six-item USDA food security scoring scale, participants had more than twice the chance of achieving a higher food security status after 8 months in either arm of the program compared to when the study began.

• Blood sugar, measured via HbA1c testing, fell by about 0.5%; and systolic and diastolic blood pressure were both lowered by about 4 mm Hg.

“The improvements in diet quality and clinical cardiometabolic factors occurred in both groups, suggesting that the dosing-down approach, when complemented by the heart-healthy eating and nutrition curriculum, had similar effects to the standard intervention dose,” Makarem said.

While large, multi-site clinical trials are needed to confirm these results, the findings suggest that food is medicine interventions could be a helpful way to improve chronic disease outcomes, particularly in populations with a high burden of cardiometabolic conditions, according to Makarem.

“Expanding eligibility, increasing accessibility and enhancing clinician referral pathways to these programs can improve diet quality and cardiometabolic outcomes, alleviate food insecurity and enhance quality of life in patients with complex and chronic medical conditions,” she said. “Considering that more than 51% of U.S. adults have two or more chronic health conditions, these interventions are a promising approach to tackle the chronic disease epidemic in communities across the country.”

"This study is important in highlighting that a gradual taper of medically tailored meals does not necessarily reduce the effectiveness of a medically tailored meal program over time,” said Kevin Volpp, M.D., Ph.D., scientific lead of the American Heart Association’s Health Care by Food initiative. “This is important since medically tailored meals are expensive, and this type of approach could be helpful in providing a more sustainable and scalable way to improve cardiometabolic health for more people."

Volpp, who was not involved in this research, is the Ralph and Beth Johnston Muller director of the Penn Center for Health Incentives and Behavioral Economics, and the Mark V. Pauley President’s Distinguished Professor at the Perelman School of Medicine and the Wharton School at the University of Pennsylvania in Philadelphia.

The American Heart Association launched the Health Care by Food initiative in 2023. The initiative works to improve health and reduce the burden of diet-related chronic diseases by integrating evidence-based nutrition interventions into healthcare systems.

Reference: Medically tailored meals improved high blood pressure, Type 2 diabetes and diet in adults, American Heart Association, Meeting :American Heart Association Scientific Sessions 2026